PELVIC ORGAN PROLAPSE

Up to 50% of women will develop a pelvic organ prolapse, which occurs when either the bladder, uterus, gastrointestinal tract or bowel loses its support and ‘falls’ into the vaginal wall because of a loss of muscle and connective tissue support. It is popularly believed to happen to only those women who have been pregnant and had a vaginal delivery but in reality, any woman can have a prolapse. Prolapses can vary in size and are graded on a scale of I-IV, with IV being the most severe. A woman may have one or more prolapses at the same time and the position of the prolapse can vary throughout the day, depending on whether she is standing, lying down or sitting. Activities that may make symptoms worse include: heavy lifting, coughing, straining with bowel movement and being on one’s feet for long periods of time. 

Pelvic organ prolapses have different names, depending on the organ involved: 

  • Bladder: cystocele or anterior vaginal prolapse  
  • Uterus: uterine prolapse 
  • Rectum: rectocele or posterior vaginal prolapse  

How would I know if I have a prolapse?

Symptoms of a prolapse include: 

  • Feelings of heaviness or bulging from the vagina
  • Heaviness in the lower abdomen
  • Leaking from the bladder or bowel (incontinence)
  • Difficulty emptying the bladder or bowel
  • Urgency or frequent trips to the bathroom for bowel or bladder
  • Frequent urinary tract (bladder) infections 
  • Painful sex

Is it safe to have sex with a prolapse?

Many women (and their partners) are concerned that further damage will be done if she has penetrative sex, but this is not true. Although some women with a prolapse may find sex uncomfortable, altering her position can often improve her sensation and experience. Discomfort during sex can also be due to other factors, such as vaginal dryness related to menopause. Try changing positions and/or adding a lubricant to your intimacy and see how you feel!